CHWs (69) Recommendation 10: Target population size

17 November, 2019

Dear HIFA colleagues,

We now enter our final week of this discussion and turn our attention to Recommendation 10 of the Guideline:


WHO suggests using the following criteria in determining a target population size in the context of CHW programmes.

Criteria to be adopted in most settings:

• expected workload based on epidemiology and anticipated demand for services;

• frequency of contact required;

• nature and time requirements of the services provided;

• expected weekly time commitment of CHWs (factoring in time away from service provision for training, administrative duties, and other requirements);

• local geography (including proximity of households, distance to clinic and population density).

Criteria that might be of relevance in some settings:

• weather and climate;

• transport availability and cost;

• health worker safety;

• mobility of population;

• available human and financial resources.

Certainty of the evidence – very low. Strength of the recommendation – conditional.


How feasible is Recommendation 10 in your country/context to determine CHW:population ratios taking these factors into consideration? If your country/programme currently does this, what tools do you use?

Best wishes, Neil

Access the CHW Guideline here:

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HIFA profile: Neil Pakenham-Walsh is coordinator of the HIFA global health campaign (Healthcare Information For All - ), a global community with more than 19,000 members in 177 countries, interacting on six global forums in four languages. Twitter: @hifa_org FB: